INTRODUCTION & BACKGROUND: Postpartum period refers to the period that begins upon the delivery of the infant to 12 months after the delivery. [1] Pregnancy and childbirth bring along several changes to a woman’s body, especially to the musculoskeletal system – mainly pelvic floor.[2,3] The primary reasons for these adaptations include weight of the gravid uterus, Changes in intra-abdominal pressure[4] Changes in intra-abdominal pressure [5,6] and strains during labor. [7,8] These adaptations lead to Obstetric Pelvic Floor Disorders. Obstetric Pelvic Floor Disorders refers to effects of pregnancy and childbirth on anatomy and function of the pelvic floor appearing up to 12 months postpartum. The joint report of International Urogynecological Association (IUGA) and International Continence Society (ICS) mentions the framework for Obstetric Pelvic Floor Disorders. They have involved the following disorders bladder storage symptoms, Postmicturition symptoms, Anorectal & Defecatory symptoms, Pelvic organ prolapse symptoms, Sexual dysfunction symptoms and Lower urinary tract pain. Aim: To develop a comprehensive Physiotherapy protocol for Obstetric Pelvic Floor Disorders in Postpartum Women. Objectives: To determine the prevalence of Obstetric Pelvic Floor Disorders among Postpartum women. To provide empirical evidence on physiotherapy management of obstetric pelvic floor disorders and factors influencing treatment in postpartum women. To develop a Comprehensive Physiotherapy Protocol for Obstetric Pelvic Floor Disorders in Postpartum Women. JUSTIFICATON FOR STUDY: Obstetric pelvic floor disorders represent a critical area of study due to their impact on women’s health. Current literature tends to focus on specific conditions within this umbrella term, often accompanied by varied terminology. Despite existing management strategies, these disorders remain highly prevalent and seemingly underreported, as the full spectrum of related conditions is not collectively studied. This study aims to address these gaps by determining the overall prevalence of obstetric pelvic floor disorders, investigating the barriers, understanding current management practices, and exploring innovative solutions in patient care. OUTCOME MEASURES: Self- made pre-validated questionnaire to determine the prevalence of obstetric pelvic floor disorders Quality of life questionnaire for obstetric pelvic floor disorders Methodology Phase 1: Prevalence Study Aim: To determine the prevalence of
symptoms of Obstetric Pelvic floor disorder in postpartum women. Objectives: To
determine the prevalence of Obstetric Pelvic floor disorder in postpartum
women To
identify the risk factors associated to obstetric pelvic floor disorders in
postpartum women. Inclusion Criteria:
- Postpartum
females in the age group of 18-40 years and within 1 year of childbirth.
Exclusion Criteria:
- Patients having symptoms of pelvic floor dysfunction before pregnancy.
Phase
2: Qualitative Study- Personal Interview method Aim: To
explore the view of stakeholders on physiotherapy management of obstetric
pelvic floor disorders and factors influencing treatment in postpartum women. Objectives: Conduct PI with gynecologists to understand their
perspective on physiotherapy management, their referral strategy, success rate
and the factors which would influence treatment in postpartum women with
obstetric pelvic floor disorders. Conduct PI with women’s health therapist to understand
common management strategies used by them and the factors which would influence
treatment in postpartum women with obstetric pelvic floor disorders Conduct PI with patients having symptoms of obstetric
pelvic floor disorders and understand their knowledge, attitude and practices
towards obstetric pelvic floor disorders, perspective towards management
strategies and the factors which would influence treatment in postpartum women
with obstetric pelvic floor disorders. Phase
3: Intervention Aim: To develop a novel and ingenious
Physiotherapy protocol for management of obstetric pelvic floor disorder in
postpartum women. Objectives:
To study
the effect of 6 weeks of management protocol on associated symptoms of
obstetric pelvic floor disorder and quality of life in postpartum women. STATISTICAL ANLAYSIS METHODS INCLUDING SAMPLE SIZE JUSTIFICATION: Phase 1 : Descriptive and Interferential statistics of the data obtained. Phase 2: Qualitative analysis – Personal interview (Gynecologist, Women’s Health Therapist and Women with Obstetric Pelvic Floor Disorders) Phase 3: Test for normality for the data Intragroup and Intergroup analysis to interpret the results SAMPLE SIZE: Phase 1: Will be determined by pilot study Personal Interview: till the saturation point is achieved Will be calculated after determining prevalence in Phase 1 INCLUSION & EXCLUSION : Phase 1: Postpartum women without any history of pelvic floor disorders prior to pregnancy Phase 2: Gynaecologist, Women’s Health Therapist (Minimum 6 patients of obstetric pelvic floor disorders in the past 6 months); Patients with symptoms of obstetric pelvic floor disorder Phase 3: Patients with symptoms of obstetric pelvic floor disorder willing to participate in the intervention |